Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 2305003663 | VA |
NPI | 1538721089 |
---|---|
Provider Name | Susan A Saliba |
First Address | Charlottesville, VA 22904-4407 |
Second Address | Charlottesville, VA 22903-2455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2019 |
Last Update Date | 05/07/2019 |